Efficacy of motivational enhancement therapy to decrease alcohol and illicit-drug use in pregnant substance users reporting baseline alcohol use.
Approximately 35% of pregnant substance users in treatment report alcohol abuse, which increases the risk of fetal alcohol spectrum disorders (FASD) in their offspring. The present study was a preliminary evaluation of the efficacy of motivational enhancement therapy (MET) in decreasing alcohol use in pregnant women attending substance use treatment, performed via a secondary analysis of a trial evaluating the efficacy of MET, relative to treatment as usual (TAU), in improving treatment outcomes in 200 pregnant substance users (CTN-0013: Motivational Enhancement Therapy to Improve Treatment Utilization and Outcome in Pregnant Substance Users). The analysis included the 41 women (n=27 MET and n=14 TAU) who reported alcohol use in the 28 days prior to randomization. Alcohol and illicit drug use days were assessed with self-report; illicit drug use was assessed with urine drug screens. All measures were obtained weekly for the 4 week active study phase and at 1 and 3 month follow-ups.
Significant treatment-by-time interaction effects were found for illicit drug use days during the active and follow-up phases and for alcohol use during the follow-up phase, all reflecting a beneficial effect for MET, relative to TAU. All other treatment effects were non-significant.
Conclusions: With FASD occurring in 2-5% of all U.S. live births, it is imperative that women who drink any amount of alcohol that could be risky to the developing fetus receive effective interventions to assist with decreased prenatal alcohol use. With approximately 35% of pregnant substance users in treatment reporting alcohol abuse, this study provides preliminary support for the use of MET to decrease prenatal alcohol use in substance using women. With a large proportion of these women abusing alcohol in combination with other substances, MET may also be useful in decreasing illicit drug use in the population, bettering outcomes for both mothers and children.
Related protocols: CTN-0013